摘要
目的评估两种麻醉药介导下脑电双频指数（BIS）与脑氧代谢率（CMRO2）的内在联系。方法30例择期全麻自愿者随机分为两组：Ⅰ组为异氟醚麻醉组，Ⅱ组丙泊酚麻醉组。Ⅰ组将呼气末异氟醚浓度分别控制在0．6％、1．2％、2．4％、3％，同时记录BIS值并测定其对应的颈内静脉血氧饱和度（SjvO2）；Ⅱ组调整丙泊酚输注速度在4、8、12、16mg·kg^-1·h^-1，同时记录BIS值并测定其对应的Sjr02。结果Ⅰ组随异氟醚浓度递增，BIS值从76±8逐渐降到34±6，SjvO2从（73．7±4．6）％升至（76．3±4．2）％，2．4％与3％的异氟醚对应的Sjr02差异也有显著意义（P〈0．05），BIS值与对应SjvO2呈显著线性负相关（r=-0．76．P〈0．05）。Ⅱ组，随丙泊酚输注速度递增，BIS值从81±6逐渐降低到38±5，SjvO2从（67．6±5．3）％升至（78．3±4．2）％。12mg·kg^-1·h^-1与16mg·kg^-1·h^-1丙泊酚输注速度时对应的SjrO2差异无显著意义。BIS值与对应SivO2呈显著线性负相关（r=0．86，P〈0．05）。结论（1）在异氟醚或丙泊酚麻醉时，BIS值随麻醉药剂量增加而显著降低，SjrO2则呈逐渐升高趋势。（2）术中血红蛋白和体温及脑血流（CBF）维持恒定，BIS值在30～100之间时，BIS与SjvO2呈显著线性负相关。（3）异氟醚或丙泊酚麻醉时，BIS可作为反映CMRO2的指标。
Objective To investigate the correlation of bispeetral index（BIS）and quantity electroencephalogram （qEEG）, with the concurrent cerebral oxygen metabolic changes induced by propofol or isoflurane anesthesia. Methods Thirty patients underwent major upper-abdominal surgery were randomized into two groups：propofol anesthesia group（groupⅠ, n=15）or i soflurane anesthesia group （groupⅡ , n= 15）. The BIS was recorded continuously during anesthesia and 5 blood samples were taken from internaljugular vein during surgery（groupⅠ： before anesthesia, isoflurane 0.6%, 1.2%, 2.4%,3.0%;groupⅡ beforeanesthesia,propofol4mg· kg^-1·h^-1,8mg·kg^-1·h^-1,12mg·kg^-1·h^-1 ,16 mg·kg^1·h^-1 for measuring SjvO2. Results Cerebral oxygen metabolism decreased with increasing level of anesthesia. In group Ⅰ, with increasing concentration of isoflurane, BIS decreased from 76±8 to 34±6 while SjvO2 increased from （73.7±4.6）% to （76.3±4.2）%. In group Ⅱ ,BIS decreasing from 81±6 to 38±5 while SjvO2 increasing from （67.6±5.3）% to （78. 3±4.2）%. A lira ear regression analysis for BIS revealed, BIS（group Ⅰ, r=0.76, P〈0.05 ; groupⅡ,r=0.86 , P〈 0.05）approached significance for explaining cerebral oxygen metabolic reduction. Conclusion BIS in the range of 30-100,is correlated linearly with the magnitude of the cerebral oxygen metabolic reduction caused by propofol and isoflurane anesthesia, suggesting that a physiologic link exists between the EEG and cerebral metabolism during anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第12期896-898,共3页
Journal of Clinical Anesthesiology
